Shared decision making (SDM) and support for self-management (SSM) refer to a set of attitudes, roles and skills, supported by tools and organisational systems, which put patients and carers into a full partnership relationship with clinicians in all clinical interactions.
In SDM and SSM patients and clinicians work together to decide on the course of action, taking into account the evidence (professional perspective) and the patient’s own preferences (patient perspective) and attaching equal value to these. It is of relevance in most clinical decision making situations, since reasonable, competing options usually exist and therefore plenty of opportunity to involve patients in those decisions.
The evidence base is irrefutable – patients want to be more involved in decisions about their health and supported to manage illness better. Those who are more involved are less anxious, more satisfied, less likely to complain and tend to enjoy better outcomes and a better quality of life than those who are less involved.
Implementing this partnership approach requires changes to the way medicine is traditionally practised. These changes are about systems and organisational processes and also require new skills and a change in the roles of both health professionals and patients.
Shared decision making at the RCP
The RCP is committed to working in partnership with patients, in clinical settings and in developing policy and guidance. In July 2013 the RCP Council adopted a position statement on SDM and SSM that set out its support for partnership working between patients and clinicians to be woven into the fabric of healthcare at every level (policy, planning, organisational and individual), including into the working of the RCP. The position statement can be downloaded below.
To support this commitment, the RCP appointed an SDM and SSM clinical fellow from 2013-2015 who was funded by the Health Foundation, and who worked with RCP departments to promote partnership working in practice.
- Person-centred care made simple animation (Health Foundation)
- Year of care
- Decision aids (Informed Medical Decisions Foundation)
- Decision aids (Health Foundation)
- Shared decision making in the NHS
- King's Fund resources
- Deciding right: care planning and the Mental Capacity Act (Northern England Strategic Clinical Networks)
- Joint Royal Colleges of Physicians Training Board (JRCPTB) guidance on training in palliative and end-of-life care for trainees (and their trainees) in non-palliative training posts
- E-learning for shared decision making